Introduction : Jaw claudication is mostly described as a symptom of giant cell arteritis. However it can also occur in presence of severe bilateral external carotid artery stenosis. Report : An 87-year-old man with extensive cardiovascular history presented with disabling bilateral jaw claudication. Duplex Scan and MR-Angiography showed severe bilateral ostial external carotid artery stenosis. After unilateral carotid endarterectomy, the symptoms disappeared. Discussion : Bilateral jaw claudication as a symptom of carotid atherosclerosis is a rare condition. It can be treated by unilateral carotid endarterectomy.